Computer-assisted interpretation of cervical cytology

Automated screening devices have the potential to increase both the sensitivity and the specificity of the cervical cancer screening process. In addition, productivity gains may be achieved with their use. In the era of HPV vaccine use, when prevalence of high-grade squamous intraepithelial lesions in the population is expected to decline, the sensitivity of manual screening will also decline. Thus, automation with its potentially superior sensitivity for rare-event detection may play an important role in morphology-based screening and triage. The increase in the prevalence of disease as presented to the screener via focused selection of important fields of view, or via selection of high-risk slides for manual review, has the potential to maintain the level of sensitivity needed to continue effective manual-based morphologic screening. Several new US Food and Drug Administration approvals in the field of automated cervical cytology screening have occurred in the past decade. These have included the so called “location-guided screening” devices that identify areas at highest risk for containing potential abnormalities—essentially providing a prescreened slide. This chapter provides an overview of the currently used systems and updates recommendations, which now include the reporting items for “location-guided screening” devices in addition to those previously covered in the second edition of this atlas.